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I am 54 and living with a permanent disability, and for the past 12 months I have been receiving Social Security disability insurance (SSDI) payments. But I do not have health insurance. I am required t...

Sep 29, 2025

FAQs

Yes, you are eligible to purchase coverage through the Marketplace, and if your expected income is at least 100% of the federal poverty level in 2026 ($15,650 for an individual) you may qualify for premium tax credits to help make Marketplace coverage more affordable. If you live in a state that has expanded its Medicaid program to cover adults under age 65 with incomes up to 138% of poverty (about $1,800 per month for an…

There are a lot of Medicare Advantage plan options in my area. How do I decide which plan is best for me?

Sep 1, 2025

FAQs

In choosing among the many Medicare Advantage plans, it is useful to think about what’s most important to you in a health plan. If you feel strongly about getting care from specific doctors and hospitals, it would be a good idea to review the provider directories of each Medicare Advantage plan to be sure the hospitals, doctors, and other health professionals that matter most to you are in the plan network. If you are most…

Ozempic’s Selection for Medicare Drug Price Negotiation Could Raise the Stakes for the Negotiation Program

Jan 17, 2025

Quick Insights

Semaglutide…has been selected for the second round of Medicare drug price negotiation…Many people are familiar with Ozempic and other drugs like it, use of these drugs has expanded rapidly in recent years, and the list price is high. All of that could focus more attention on this year’s drug price negotiation process….

Medicaid Eligibility Levels for Older Adults and People with Disabilities (Non-MAGI) in 2026

Apr 30, 2026

Issue Brief

KFF’s Survey of Medicaid Financial Eligibility for Older Adults & People with Disabilities, conducted in March 2026 by KFF and Watts Health Policy Consulting, provides a baseline of Medicaid eligibility ahead of potential changes to the Medicaid program stemming from the 2025 reconciliation law.

How Recent Manufacturer Savings Programs May Impact Individual Out-of-Pocket Spending on Asthma and COPD Inhalers

Aug 11, 2025

Issue Brief

A new analysis shows that individuals with employer insurance could save 41% on their out-of-pocket spending for asthma and COPD inhalers through manufacturer savings. In response to a U.S. Senate investigation into inhaler costs, 3 drug makers voluntarily capped out-of-pocket costs on their brand-name asthma and COPD inhalers.

I am turning 65 next year. When can I sign up for Medicare?

Sep 1, 2025

FAQs

If you are eligible for Medicare, your initial enrollment period for Part A and Part B begins three months before the month of your 65th birthday and ends three months after it. For example, if your 65th birthday is in June, your enrollment period will extend from March 1 through September 30. If you join during one of the 3 months before you turn 65, coverage will begin the first day of the month you…

I am currently enrolled in a Medicare Advantage plan, but I received a notice that my plan is not being offered next year. What do I need to do?

Sep 1, 2025

FAQs

If your current Medicare Advantage plan is not being offered next year and you do not choose another plan, you will be enrolled by default in traditional Medicare. In this case, if you do not receive Extra Help with your Part D drug costs, then you will need to select a Part D prescription drug plan (PDP) if you want Medicare drug coverage, unless you have drug coverage from another source of coverage (for example,…

I am 54 and living with a permanent disability, and for the past 12 months I have been receiving Social Security disability insurance (SSDI) payments. But I do not have health insurance. I am required t...

Sep 1, 2025

FAQs

Yes, you are eligible to purchase coverage through the Marketplace, and if your income is between at least 100% of poverty (for buying Marketplace coverage in 2026, that means an income of $15,650 for an individual) you will qualify for premium tax credits to help make Marketplace coverage more affordable. If you live in a state that has expanded its Medicaid program to cover adults under age 65 with incomes up to 138% of poverty…

People with Medicare Will Face Higher Costs for Some Orphan Drugs Due to Changes in the New Tax and Budget Law

Oct 20, 2025

Issue Brief

This brief analyzes changes in the new tax and budget reconciliation law that modify which drugs will be selected for Medicare drug price negotiation, which will lead to higher Medicare spending and higher costs for beneficiaries who take these medications.

Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries

Oct 27, 2025

Issue Brief

Medicare Advantage enrollees were in a plan that included just under half (48%) of all physicians available to traditional Medicare beneficiaries in their area in 2022, on average. The limitations of provider networks illustrate one of the key tradeoffs for beneficiaries in choosing Medicare Advantage for their coverage.

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